Pre and Perimortem - Lecture 16 Flashcards
What does Pre/Ante Mortem mean?
trauma occurring before death
What does Perimortem mean?
trauma occurring around the time of death
What are the three phases of healing?
- Inflammatory phase
- Reparative phase
- Remodelling phase
Explain what happens in the Inflammatory phase.
- a hematoma (blood clot) will form in the periosteum within 48 hours and osteoblasts will travel through blood cells to begin bone formation in the extend of the hematoma
- granulation tissue forms between the fragments between 7-14 days
- revascularization will occur followed by cartilage and woven born forming through endochondral ossification
- soft callus of woven bone and cartilage forms with the periosteum forming around it within 4-16 weeks
What is Granulation tissue?
tissue matrix precursors to connective tissue and blood vessels
What is Revascularization?
when new blood vessels connect with previous blood cells
Explain what happens in the Reparative phase.
- woven bone is replaced by lamellar bone and a hard but weak bone callus is formed
- resulting in a clinical union which means bone has formed all around
Explain what happens in the Remodelling phase.
- cortical and trabecular bone from taking on the shape of the hematoma
- bone callus is still visible but can be remodelled out years after break
What increases risk of premortem fractures?
- Pathologies (diseases)
- Nutrition issues
- Activity
What is Osteogenesis imperfecta?
- a bone disease (pathology) that increases risk of fracture
- brittle bone disease
- mutation affects collagen production and the bone will be like chalk
What is Osteopenia?
- pre osteoporosis
- the beginning of a deep decline in bone density
What is Osteoporosis?
- loss of trabecular bone
- loss of bone density
- a reabsorption of bone without a deposition of bone
What is Scurvy?
a nutritional deficiency with the lack of vitamin C that affects collagen production causing brittle bones
What kinds of activity can increase risk of premortem fractures?
- falls or accidents
- beatings which are forensically relevant
- child abuse which is also forensically relevant
What are the main fractures that are due to osteoporosis?
- Hip fractures
- from the femoral neck
- or between the greater and lesser trochanter
- or below the lesser trochanter - compression fractures in the vertebral bodies
- known as kyphosis
- causes the body to pitch forward - Colle’s fracture
- compression fracture of the distal radius
- from falling back with your arms extended
What are the main fractures that are due to scurvy?
- Cortical bone thinning
- a reabsorption of bone without a deposition of bone
- can cause tooth loss since alveolar cavities are already thin - Porotic hyperostosis
- thinning and destruction of the cranial vault
What are the main fractures caused by activity?
- Parry fracture
- result of shielding yourself with your arm from being hit
- fracture of the ulna and/or radius - Pseudarthrosis (new joint)
- a new joint that forms from continued movement and activity between the ends of the broken bone
- a nonunion of bone
- can indicate someone being continually exposed to abuse
What can fractures in young children be indicative of? Why? What should you look out for?
- abuse because children are more resistant of breaking bones due to higher collagen production leading to higher bone flexibility
- look at the type and location of fracture, age of the child, and manner of the injury
With children under a year old what are locations of fractures that are indicative of child abuse? What specific action caused them?
- ribcage
- metaphyses
- cranium
- shaking, squeezing, or hitting
What children over a year what are locations of fractures that are indicative of child abuse? What specific action caused them?
- cranium
- long bones
- pulling, twisting, or punching
What are repeated fractures in the same area indicative of in children?
child abuse
What are the healing rates of a Neonate? An 8 year old? A 12 year old? A 20 year old?
- reunite within 3 weeks
- 8 weeks
- 12 weeks
- 20 weeks
Are there signs of healing with perimortem trauma? Is perimortem trauma always the cause of death?
- no evidence of healing
- may or may not be cause of death
What are the two different classifications of death? What are their definitions?
- Cause of death
- a biomedical explanation of the trauma, disease, or event that started the physiological process leading to death - Manner of death
- legal distinction for the way someone died
- homicide, suicide, accident, natural causes, unknown
